{¶1}
This case arises from a July 21, 2013 accident in which
plaintiff, an inmate in the custody and control of defendant,
fell and was injured while adjusting a window at the
Chillicothe Correctional Institution (CCI). The issues of
liability and damages were bifurcated, trial was held on the
issue of liability, and the magistrate recommended judgment
in favor of plaintiff. The court adopted the magistrate's
decision and entered judgment accordingly. The case then
proceeded to trial on the issue of damages.

{¶2}
It was established during the liability phase of trial that
the accident occurred while plaintiff climbed up a wall above
the top of the recreation cage in the segregation unit at CCI
and that plaintiff fell backward and landed on the metal
covering atop the cage. At the damages phase of trial,
plaintiff testified that he was at least five feet above the
cage when he fell. Plaintiff stated that he remembers landing
on top of the cage but that he apparently lost consciousness
for a moment and then regained it while people were attending
to him. Plaintiff further stated that he vomited around that
time.

{¶3}
Plaintiff recalled inmates and corrections officers carrying
him off the top of the cage and putting him on a bench.
Plaintiff testified that his back and his head hurt, that he
continued to vomit, and that he was bleeding from the right
elbow where a piece of metal atop the cage had punctured his
arm by a half inch or less. Someone gave him a towel to stop
the bleeding on his arm, plaintiff stated. Plaintiff recalled
a nurse coming to the segregation unit and asking him what
happened, and that after he explained it to her, she and the
corrections officers went aside and talked amongst
themselves, whereupon she came back and told him he would be
taken to the infirmary only because of the wound on the
elbow. Plaintiff testified that he was put in a cart and
transported to the infirmary, where he received a tetanus
shot and was then sent back to the segregation unit.
Plaintiff stated that he was not given any medication, that
his lower back and neck hurt, and that he remained awake and
nauseous all night, afraid to go to sleep.

{¶4}
According to plaintiff, when the first shift corrections
officer arrived in the unit the next morning and learned
about the accident, he sent plaintiff back to the infirmary.
Plaintiff stated that a nurse looked at him but provided no
treatment and sent him back to the segregation unit. At this
point, plaintiff stated, he remained in pain and did not know
what to do. Plaintiff explained, though, that the warden
subsequently came through the segregation unit while making
rounds and he was able to get the warden's attention and
tell him what happened. By plaintiffs account, the warden
seemed surprised that he had not heard about the accident and
he ordered that plaintiff be sent to the infirmary and
provided treatment. Plaintiff stated that when he went to the
infirmary this time, he was given an x-ray of the skull and
was told that he showed signs of having a concussion.
Plaintiff related that he was sent back to the segregation
unit again, still feeling pain in his neck, back, and head.
Plaintiff acknowledged that in his visits to the infirmary at
CCI, he did receive some treatment from nurses, but in his
opinion the treatment was inadequate.

{¶5}
Early the next morning, plaintiff testified, he was
transferred to the Noble Correctional Institution (NCI).
Plaintiff acknowledged that in the following weeks he
received medical attention several times at NCI, including
multiple doctor visits, but from his perspective he did not
get treatment that he felt was appropriate. Plaintiff
admitted that in addition to the x-ray he underwent on July
24, 2013, medical records reflect that he received another
skull x-ray on August 1, 2013, thoracic and lumbar spine
x-rays on August 7, 2013, thoracic spine and elbow x-rays on
September 6, 2013, and a cervical spine x-ray on September
13, 2013, none of which identified any fractures.
(Defendant's Exhibit C.) According to plaintiff, however,
he felt that he should have been given an MRI, which he never
received. To the extent that the records from the x-rays show
that they were interpreted as indicating mild scoliosis in
the thoracic spine and mild degenerative changes in the
cervical spine, plaintiff testified that no one had ever
diagnosed him with these conditions prior to the accident,
and he testified that he never had any back problems at all
before the accident.

{¶6}
Plaintiff testified about submitting an Informal Complaint
Resolution form on September 9, 2013, in which he complained
that a doctor who examined him at NCI apparently thought he
might have a vision problem, whereas plaintiff thought that
he should have undergone an MRI or additional x-rays.
(Plaintiffs Exhibit 15.) Plaintiff admittedly complained to
NCI medical personnel about having blurry vision at some
point and underwent an eye exam which resulted in a finding
that his blurry vision was caused by an eyesight problem, but
he stated that he never had any such problems before the
accident. Plaintiff also testified about an Informal
Complaint Resolution form that he submitted on September 25,
2013, complaining that he had been denied an MRI. (Plaintiffs
Exhibit 16.) Plaintiff stated that on October 2, 2013, he
sent a "kite" (a handwritten form of institutional
correspondence) to the Health Care Administrator at NCI
complaining about having been prescribed rubber band
exercises for his back, which were painful, rather than an
MRI. (Plaintiffs Exhibit 13.) Plaintiff further stated that
on October 17, 2013, he submitted another kite to the Health
Care Administrator at NCI complaining about medications he
had been prescribed for high blood pressure and migraine
headaches, which he felt were not applicable to his symptoms.
(Plaintiffs Exhibit 14.) Plaintiff admitted that he received
responses to his complaints, whether he agreed with them or
not, including explanations that his treatment plan was
ordered by the doctor, that he needed to start out slowly
with the rubber band exercises and build strength, and that a
collegial review panel had reviewed his case and determined
that an MRI was not warranted, and he was also scheduled for
follow-up visits with the doctor. According to plaintiff,
however, in spite of the medical attention that he received
at NCI, he felt that overall nothing was really done for him.

{¶7}
The pain and stiffness in his neck eventually went away,
plaintiff stated, and although the head and back pain
persisted, the level of pain decreased somewhat over time.
Plaintiff related that he served out his sentence and was
released after about a year and a half at NCI, at which time
he still suffered from headaches and low back pain. According
to plaintiff, when he returned home to Gallipolis he had
difficulty obtaining medical attention on account of not
having health insurance, but there was a physician he was
able to see a couple of times who performed tests and
prescribed some kind of medication for him. Plaintiff
described getting some temporary relief from the medication
but that the underlying problems remained.

{¶8}
About one year after being released from NCI, plaintiff
stated, he was arrested and jailed in Meigs County for about
seven months. Plaintiff testified that the pain in his head
would come and go and was intense when it would happen, while
the lower back pain was more constant. Plaintiff stated that
he got some medical attention in the jail, including some
medication which was ineffective for relieving his pain, and
that he was scheduled to undergo an MRI and a CAT scan, but
before the tests could be performed he was convicted on a
felony charge and conveyed to defendant's custody.
Plaintiff related that he was admitted into defendant's
Correctional Reception Center (CRC) and that he sought
medical attention there but nothing was done for him.
Plaintiff testified that defendant transferred him to NCI in
2016 and that he had been there for about one year at the
time of trial. Plaintiff testified that he is not taking any
medication and that he still feels that he is not getting
appropriate care. Plaintiff described the present symptoms
that he attributes to the accident as intense low back pain,
slightly below his belt line, in both sides of the back, and
also headaches, which are more problematic to him than the
back pain.

{¶9}
Rayma Jensen, R.N. testified by way of deposition.
(Plaintiffs Exhibit 17.) Jensen has worked for defendant at
CCI since 2009, and at the time when the accident occurred
she probably served as a Nurse I assigned to an
"ER" role in the infirmary, she stated. Jensen
testified that on the evening when the accident took place
she was summoned to the segregation unit to examine
plaintiff. Jensen testified that she vaguely recalled the
encounter, at which time she believes plaintiff was seated on
a bench or chair, but that she filled out a Medical Exam
Report to document what occurred. (Plaintiff s Exhibit 7.)

{¶10}
Jensen stated that, according to what she wrote in the
Medical Exam Report, plaintiff told her that he fell and hurt
his back and sustained a puncture wound to his arm. The
Medical Exam Report shows that Jensen measured plaintiffs
vital signs and his pupils, which were normal, and determined
that he was alert and oriented, she stated. Jensen stated
that she documented a small hole in the right arm below the
elbow with minimal bleeding, which she cleaned and applied
ointment to before covering it with a bandage. Jensen also
noted a small knot on the back of the head which she advised
plaintiff to apply ice to, she stated. Jensen stated that she
did not note any discoloration in the lower back where
plaintiff complained of pain, but she acknowledged that
bruises do not typically appear immediately after an
accident. Jensen testified that she apparently transported
plaintiff to the infirmary on a cart and set up a referral
for him to see the doctor during "sick call" hours,
but that she is not personally aware of any other treatment
plaintiff received. When questioned about a July 21, 2013,
doctor's order by a Dr. Akhtar, Jensen testified that it
appears to reflect that the doctor gave an order over the
telephone to another nurse that night for plaintiff to be
given a tetanus shot. Plaintiffs medical chart shows that he
was transferred from CCI to NCI on July 25, 2013, Jensen
testified.

{¶11}
Nicole Estep, R.N. testified by way of deposition.
(Plaintiffs Exhibit 18.) Estep, who stated that she has been
employed with defendant for 10 years as a nurse at CCI,
related that she prepared a Medical Exam Report during an
examination that she performed on plaintiff on July 22, 2013,
at 9:40 a.m. (Plaintiffs Exhibit 12.) According to what she
wrote in the Medical Exam Report, Estep stated, plaintiff
complained of headaches and back pain which he attributed to
falling the day before. Estep stated that she does not recall
if she examined plaintiffs head, but that the only visible
injury she noted was a small abrasion on the right elbow.
Estep further stated that this was the only time she saw
plaintiff. Estep stated that she does not have any knowledge
about the x-rays that plaintiff underwent, but she explained
that they can be performed at CCI.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;{&para;12}
Vanessa Sawyer, R.N. testified that she is employed with
defendant as the Health Care Administrator at NCI, where she
has worked for approximately 21 years, and that her job
entails overseeing all aspects of the ...

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